Na farko "taron" tare da jariri, na farko trimester duban dan tayi yana ɗokin jiran iyaye na gaba. Har ila yau ana kiransa Dating duban dan tayi, yana da mahimmanci wajen haihuwa.

Duban dan tayi na farko na ciki yana faruwa tsakanin 11 WA da 13 WA + 6 days. Ba dole ba ne amma yana daya daga cikin 3 ultrasounds systematically miƙa wa iyaye mata da kuma shawarar sosai (HAS shawarwari) (1).

Na farko trimester duban dan tayi yawanci ana yi ta hanyar ciki. Ma'aikacin ya shafa cikin mahaifiyar da za ta kasance tare da ruwan gelled don inganta yanayin hoton, sannan ya motsa binciken a cikin ciki. Mafi wuya kuma idan ya cancanta don samun ingantaccen bincike, ana iya amfani da hanyar farji.

Ultrasound baya buƙatar ku sami cikakkiyar mafitsara. Jarabawar ba ta da zafi kuma amfani da duban dan tayi ba shi da lafiya ga tayin. Yana da kyau kada a sanya cream a ciki a ranar duban dan tayi saboda wannan zai iya tsoma baki tare da watsawa na duban dan tayi.

Ɗaya daga cikin makasudin wannan duban dan tayi na farko shine tantance shekarun haihuwa don haka kwanan watan ciki daidai da lissafin bisa ranar da aka fara lokacin ƙarshe. Don wannan, mai yin aikin yana yin nazarin halittu. Yana auna tsayin cranio-caudial (CRL), wato tsayin da ke tsakanin kai da gindin amfrayo, sannan ya kwatanta sakamakon tare da lanƙwan tunani da aka kafa bisa ga dabarar Robinson (shekarun haihuwa = 8,052 √ × (LCC) ) +23,73).

Wannan ma'aunin yana ba da damar ƙididdige ranar fara ciki (DDG) tare da daidaito na ƙari ko ragi kwanaki biyar a cikin 95% na lokuta (2). Wannan DDG zai kuma taimaka wajen tabbatarwa ko gyara kwanan watan da aka gama (APD).

A wannan mataki na ciki, mahaifa ba ta da girma sosai, amma a ciki, amfrayo ya riga ya ci gaba sosai. Yana auna tsakanin 5 zuwa 6 cm daga kai zuwa gindi, ko kuma kusan 12 cm a tsaye, kuma kansa yana da kusan 2 cm a diamita (3).

Wannan duban dan tayi na farko yana nufin duba wasu sigogi da yawa:

• yawan tayi. Idan ciki tagwaye ne, mai yin aikin zai tantance ko ciki tagwaye ne guda ɗaya (mace guda ɗaya ga 'yan tayin) ko kuma bichorial (mace guda ɗaya ga kowane tayin). Wannan ganewar asali na chorionicity yana da matukar muhimmanci saboda yana haifar da bambance-bambance masu ban sha'awa game da rikitarwa kuma sabili da haka hanyoyin bin ciki;
• muhimmancin tayin: a wannan mataki na ciki, jaririn yana motsawa amma mahaifiyar da za ta kasance ba ta ji ba tukuna. Yana kadawa, ba da son rai ba, hannu da kafa, yana miƙewa, ya murɗa ƙwallon, kwatsam ya huta, yayi tsalle. bugun zuciyarsa, mai saurin gaske (kira 160 zuwa 170 a cikin minti daya), ana iya ji shi akan doppler duban dan tayi.
• Halin halittar jiki: mai yin aikin zai tabbatar da kasancewar dukkanin gabobin jiki guda hudu, ciki, mafitsara, kuma zai duba ma'aunin cephalic da na bangon ciki. A gefe guda, har yanzu yana da yawa don gano yiwuwar tabarbarewar halittar jiki. Zai zama duban dan tayi na biyu, wanda ake kira morphological, don yin shi;
• adadin ruwan amniotic da kasancewar trophoblast;
• nuchal translucency (CN) ma'auni: a matsayin wani ɓangare na haɗe-haɗen nunawa don ciwon Down (ba dole ba ne amma ana ba da shi ta tsari), mai yin aikin yana auna ma'auni na nuchal, ƙanƙara mai kyau cike da ruwa a bayan wuyan tayin. Haɗe tare da sakamakon gwajin alamar ƙwayar cuta (PAPP-A da beta-hCG kyauta) da shekarun haihuwa, wannan ma'auni yana ba da damar yin lissafin "haɗaɗɗen haɗari" (kuma ba don yin ganewar asali) na chromosomal rashin daidaituwa.

Game da jima'i na jariri, a wannan mataki tubercle na al'aura, wato tsarin da zai zama azzakari na gaba ko clitoris na gaba, har yanzu ba shi da bambanci kuma kawai yana da nauyin 1 zuwa 2 mm. Yana yiwuwa duk da haka, idan jaririn yana da kyau, idan duban dan tayi ya faru bayan makonni 12 kuma idan mai aiki yana da kwarewa, don ƙayyade jima'i na jariri bisa ga daidaitawar tubercle na al'aura. Idan ya kasance daidai da kusurwar jiki, yaro ne; idan ya kasance a layi daya, yarinya. Amma a kula: wannan hasashen yana da gefen kuskure. A ƙarƙashin mafi kyawun yanayi, 80% kawai abin dogaro ne (4). Don haka gabaɗaya likitoci sun gwammace su jira na'urar duban dan tayi na biyu don sanar da jima'i ga iyayen da za su haifa, idan suna son saninsa.

• zubar da ciki : jakar amfrayo akwai amma babu aikin zuciya kuma ma'aunin tayi ya yi kasa da na al'ada. Wani lokaci yana da "kwai bayyananne": jakar gestational ya ƙunshi membranes da mahaifa na gaba, amma babu amfrayo. Ciki ya ƙare kuma tayin bai girma ba. A cikin abin da ya faru na zubar da ciki, jakar ciki na iya fita ba tare da bata lokaci ba, amma wani lokacin ba haka ba ne ko bai cika ba. Sannan ana ba da magunguna don haifar da natsuwa da haɓaka cikakkiyar ficewar tayin. Idan akwai rashin nasara, za a yi aikin tiyata ta hanyar buri (curettage). A kowane hali, kulawa ta kusa wajibi ne don tabbatar da cikakken fitarwa na samfurin ciki;
• ciki ectopic (GEU) ko ectopic: kwai ba a dasa shi a cikin mahaifa ba amma a cikin proboscis saboda ƙaura ko cutar dasa. GEU yawanci yana bayyana da wuri a cikin ci gaba tare da ciwo na ƙananan ciki na gefe da zubar jini, amma wani lokacin ana gano shi ba zato ba tsammani yayin duban dan tayi na farko. GEU na iya ci gaba zuwa korar da ba zato ba tsammani, tsayawa ko girma, tare da haɗarin fashewar jakar ciki wanda zai iya lalata bututu. Kulawa tare da gwaje-gwajen jini don tantance hormone beta-hcg, gwaje-gwaje na asibiti da duban dan tayi yana ba da damar saka idanu akan juyin halittar GEU. Idan ba a matakin ci gaba ba, magani tare da methotrexate yawanci ya isa ya haifar da fitar da jakar ciki. Idan ya ci gaba, ana yin aikin tiyata ta hanyar laparoscopy don cire jakar ciki, wani lokacin kuma bututu idan ta lalace;
• mafi kyau fiye da al'ada nuchal translucency ana yawan gani a jariran da ke da trisomy 21, amma wannan ma'auni ya kamata a haɗa shi a cikin haɗakar gwajin trisomy 21 tare da la'akari da shekarun haihuwa da alamun jini. A cikin yanayin haɗakar sakamako na ƙarshe sama da 1/250, za a ba da shawarar kafa karyotype, ta trophoblast biopsy ko amniocentesis.